Managing work and family responsibilities in the U.S. is often difficult and impacts the health and well-being of employees, their families, and the workplace. Although the prevalence of work-life policies in U.S. workplaces has increased dramatically in recent years, there are few longitudinal studies using experimental designs to evaluate the effects of specific work-family interventions on work-family conflict and worker health outcomes. To address this critical gap in the knowledge base supporting work-family policies, the National Institutes of Health (NIH) and the Centers for Disease Control and Prevention (CDC) formed the Work, Family, and Health Network (WFHN). After 3 years of NIH- and CDC-funded pilot and formative research, the Work, Family and Health Network has embarked on a major ($31M) study of the effects of a specific behavioral workplace intervention evaluated in a multi-level framework at the workplace (30 sites), work group (~ 7 per worksite), employee (n=1500), and employee family levels. This parent project evaluates an innovative workplace intervention designed to reduce work-family conflict on the health, particularly cardiometabolic and sleep health, of direct patient-care employees in the long-term health care industry. This intervention is designed to decrease work-family conflict for employees, but has the potential of increasing the organizational support for the work-family needs of mid-level managers-those supervisors in the trenches who deal with the day to day work life and supervision of employees-leading to improved health of these managers. In this ancillary study proposal, we propose to study managers (n=163) at 28 worksites in parallel with the parent study data collection from 2010 through 2013. We propose to assess mid-level managers' cardiometabolic and sleep health using measures identical to the parent study assessments in employees. Specifically, we hypothesize that 1) an effective workplace intervention focused on manager practices and employee empowerment will ultimately reduce manager stress, which we operationalize as decreased cardiometabolic disease risk and increased manager sleep duration (at 6-, 12-, 18-month follow-ups post-intervention); and 2) that the effects of the workplace intervention on directly-measured managers health (cardiometabolic disease risk and sleep) will be associated with employees' directly-measured health (cardiometabolic disease risk and sleep) at the 6-, 12, 18-month follow-ups. To test these hypotheses we will also develop novel and broadly applicable statistical methodologies for variable selection to identify predictors of the outcomes in longitudinal studies in the presence of missing data, using a penalized likelihood approach. We extend the conceptual framework of the parent study by including manager-level objective health measures that enable the evaluation of the effects of the workplace intervention, versus continued usual practice, on manager health outcomes. This proposal represents a unique and time-sensitive opportunity to study the multi-level factors influencing health and chronic cardiometabolic disease risk in the workplace. PUBLIC HEALTH RELEVANCE: Narrative Although the prevalence of family-friendly or work-life policies in U.S. workplaces has increased dramatically in recent years, few longitudinal experiments have evaluated the effects of work-family interventions on employee health outcomes. The Work, Family and Health Study is an ongoing, randomized, controlled trial of an innovative workplace intervention to improve employee health. This time-sensitive Ancillary Study proposal adds objective health outcomes in mid-level managers, a focus of the intervention, to evaluate the effects of this workplace intervention on managers' cardiometabolic and sleep health, and represents a unique opportunity to study the multi-level factors influencing health in the workplace. (End of Abstract)